Truths and Misconceptions about Isotretinoin for Acne

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Dr. Alicia Cool with Advanced Dermatology explains Isotretinoin, (Accutane) and offers tips on why it still can be the best treatment for those with moderate to severe acne.

Dr. Alicia Cool

Isotretinoin can be the answer people with moderate to severe acne have been looking for. With the tools that we have, most cases of acne can be controlled.

According to the Center for Disease Control in Atlanta, 8 out of 10 teens have acne and nearly half of people in their 20’s and 30’s continue to have it. It’s the eighth most common disease worldwide. With all the acne treatments available such as benzoyl peroxide, salicylic acid, and topical and oral antibiotics, many people find a cure or at least significant relief. But for those suffering with moderate to severe acne, these treatments may not help. “Oftentimes when people with severe acne come to see me,” explains Dr. Alicia Cool, dermatology specialist with Advanced Dermatology PC, “they’re desperate. They’ve tried a myriad of treatments and nothing has worked.”

Severe acne is classified as having cysts or nodules five millimeters or greater. These cysts may be painful and can leave scars when they heal, and not just physical scars. “Acne is not just a physical disease,” says Dr. Cool, “it also takes its toll mentally and emotionally. It can lead to low self-esteem, avoidance of situations and even depression. That’s why it’s so important to provide these patients with something that’s truly effective.”

Since 1982, when Isotretinoin was first developed, it has remained the most efficacious treatment for severe acne, as well as for moderate acne that is unresponsive to other treatment modalities. It’s the only treatment that works on all causes of acne, the main one being puberty. When puberty hits, the oil glands go into overdrive and the excess oil combines with dirt, bacteria and cells inside the skin’s pores. This mixture causes a sticky plug that becomes a pimple.

Isotretinoin works to break this cycle by reducing oil production in the skin, while shrinking the size of the pores. It also has anti-inflammatory properties.

“It is still considered the biggest breakthrough for acne since it was developed,” says Dr. Cool. Isotretinoin is the only drug with the potential to clear severe acne after 1 course of treatment, a course being four to six months. It provides significant improvement in 80% of patients and complete remission in over 50% of people.

Tips on understanding the truths and myths about Isotretinoin
So if it’s so effective, why wouldn’t everyone with acne use it? “It’s the potential side effects that people worry about,” says Dr. Cool, “the biggest being the high risk of birth defects if a woman becomes pregnant while taking Isotretinoin.” Dr. Cool adds that if used correctly the risks are manageable. Thus women in particular are highly scrutinized before and during use. “Before a woman can go on Isotretinoin,” Dr. Cool explains, “she must have not one, but two, pregnancy tests. She must also document to her doctor that she is on acceptable birth control while taking Isotretinoin. Under the proper care of your physician, these risks can be monitored and minimized, or even eliminated entirely.”

Other side effects of Isotretinoin can include dry lips, dry mouth, minor swelling of eyelids and lips, dry skin, nosebleeds, muscle aches, upset stomach and thinning of the hair. Isotretinoin also carries an association with depression, so patients with a history of mental health problems should discuss this with their provider during consultation. Isotretinoin can be the answer people with moderate to severe acne have been looking for. “With the tools that we have, most cases of acne can be controlled,” says Dr. Cool.

Bio: Alicia Cool, M.D., F.A.A.D., is a board-certified dermatologist, specializing in all areas of medical dermatology, skin cancer prevention and treatment and cosmetic dermatology.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation with 13 locations in New York and New Jersey, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. http://www.advanceddermatologypc.com.

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